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Answers to common questions about the electronic health record for doctors

The electronic patient record has existed since January 1st, 2021. Users can manage and share health data there. This should facilitate the exchange of information. We are providing doctors with extensive background information on this new offer.

The most important questions about the electronic patient record (EPR) and answers for doctors at a glance

What is the electronic patient record (EPR)?

The electronic patient record is a digital platform for the documentation and exchange of health data. It is made available to the insured by the statutory health insurance companies. Patients can use it to manage their treatment-relevant documents - voluntarily, securely and for life. With the consent of the patient, doctors, dentists, pharmacists, psychotherapists, hospitals or therapists have access to this data. In this way, the electronic patient file enables service providers to have a quick and comprehensive insight into the respective medical history, but also simplifies the exchange of information between all those involved.

What role does the telematics infrastructure (TI) play?

The electronic patient record is accessed via the telematics infrastructure (TI). The TI is a closed network that securely connects doctors, psychotherapists, hospitals, pharmacies and other service providers in the German healthcare system. It is separated from the public Internet, only registered users (persons and institutions) have access. Sensitive medical information that is necessary for treating patients can be transmitted more quickly and easily via the TI.

Who has access to the electronic patient record?

Patients and their authorized service providers have access to the electronic patient record. Patients use the ePA app for smartphones or tablets to read the saved health documents, upload new documents and share them with doctors or other service providers. Authorized doctors can view the documents collected in the electronic patient file via their practice management system and, if necessary, update the information. The presence of the patient is not necessary for this, provided that they have allowed access over a longer period of time.

Why and when will the electronic patient record be introduced?

The Appointment Service and Supply Act (TSVG) obliges the statutory health insurance companies to provide their insured persons with an electronic patient file in accordance with Section 291a SGB V by January 1, 2021 at the latest.

How do I benefit from the electronic patient record?

The electronic patient record enables more cooperation in the healthcare system. As a comprehensive platform, it makes care even more transparent: if a patient introduces herself to the practice, the electronic patient file provides a compact overview of the medical history. Findings can be digitally and securely shared with colleagues via the TI. The attending physicians and service providers have all information relevant to them about previous illnesses, diagnoses, previous operations, medication taken or allergies available at all times. This makes decisions easier and simplifies work processes.

Are there differences between the electronic patient files of the health insurance companies?

All statutory health insurance companies are subject to the technical safety and functionality requirements that have been defined by the legislator and the gematik responsible for the introduction of the electronic patient file. In this respect, all electronic patient files are based on the same basic functions.

What are the basic functions of the electronic patient record?

The basic functions of the electronic patient record allow patients and the service providers authorized by them to upload or download medical documents such as findings and diagnoses and to read them. Patients can also manage access rights and see which line providers have access to their electronic health record.

Questions about access to the ePA for doctors

You receive access from your patients themselves. They decide whether your practice or another service-providing institution, such as a hospital or pharmacy, can view the data in the electronic patient record and upload or edit documents in it. Patients grant access either via their ePA app or directly in the practice using their electronic health card and PIN. Patients also determine how long a care provider has access to their electronic patient record. Access rights can be granted from 1 day to 18 months.
Your practice or hospital requires specific technical equipment that is connected to the telematics infrastructure to access your patients' ePA.
This will be made available by the manufacturers of your IT or practice management system in the course of 2021.

Questions about the use of the EPR by doctors

Doctors can place health documents in the electronic patient record, download and read them, provided that their patients have given them the necessary access rights. The deletion of documents is only possible in consultation with the patient. Since they have sovereignty over their data, they have to give their express consent.

So that the electronic patient record can make the planning, control and documentation of health-related measures more transparent and easier, all relevant documents should also be stored there. This applies not only to documents that are important for the treatment of the patient in one's own practice, but also to data that could be important for colleagues or other service providers. These include:

  • the medication schedule for patients taking three or more prescription drugs at the same time;
  • the emergency data set, which in an emergency makes medical data such as diagnoses, allergies or intolerances accessible and, if available, can contain information on the storage location of documents such as the health care proxy, living will or the declaration on organ and tissue donations;
  • Electronic doctor's letters (e-doctor's letters), in which important information on the course of illness is documented and which should be shared with colleagues, for example in the event of a referral.
  • Laboratory results, therapy and treatment reports, findings or diagnoses. These can also be placed in the electronic patient file in unstructured form, for example as a PDF.

The health information of patients should be updated when this for example

  • are taking a new prescription drug to add to their medication schedule;
  • receive a new diagnosis or show an intolerance that has not yet been recorded in the emergency data set.

A marking function is also planned: Doctors should be able to mark documents uploaded by their patients as medically relevant in order to make other practitioners aware of them. These can be, for example, vital parameters that patients record at home using a mobile EKG, blood pressure monitor, or even a pain diary.

Yes. For the first time the file is filled in in 2021, the medical professionals will receive a one-time fee of 10 euros. Hospitals are also entitled to a surcharge of 5 euros for entering data that arose as part of hospital treatment. Patients have the right to have doctors fill in their files.

All common formats such as PDF and JPEG are compatible with the electronic patient record. Existing documents such as diagnoses, laboratory results, therapy and treatment reports can be scanned or photographed and entered as a digital version in the electronic patient record.

Standardized medical documents can also be saved and read out in the electronic patient file. The standardization ensures that these are displayed uniformly in all common practice management systems and hospital information systems. The first three standardized documents that are available in the zru electronic patient file are the medication plan, the emergency data record and the e-doctor's letter. Further standardized documents such as the dental bonus booklet, the mother's passport or the U booklet are to follow.

Patients can upload, download and read health documents in their electronic health record.

You determine which practices, hospitals or pharmacies have access to your electronic patient record and for how long. The duration of the access rights ranges between 1 day and 18 months. Patients can also revoke these rights if necessary.

Patients can read medical documents, but they cannot change them. To do this, they need to contact the attending physician.

The electronic patient record is aimed at everyone, both healthy and sick people. It enables them to store their health information and documents in a centralized and standardized manner. Anyone who opts for an electronic patient file will always have the most important medical documents to hand and can update them again and again.

The electronic patient record saves time, especially for patients with chronic illnesses or long and complex illness histories. It simplifies documentation and makes it more secure at the same time.

Even insured persons without a smartphone can have their files maintained by their doctors. To do this, you must register in the practice with your electronic health card in the electronic patient file and grant the appropriate access rights.

Important answers on the subject of data protection in the electronic patient record

The electronic patient record is a digital folder with protected access via the telematics infrastructure (TI). Your content is not stored on the electronic health card (eGK), but is encrypted on servers outside the practices but within the European Union.

Only the insured himself and the service providers authorized by them are allowed to open the electronic patient file and view the documents it contains.

Gematik tests all ePA file systems before they are approved so that health data can be securely stored and managed in them.

The data security of Barmer eCare corresponds to the extremely high requirements of the Federal Office for Information Security (BSI) and gematik.

Questions about Barmer eCare

The Barmer electronic patient file is more than a digital folder. Right from the start, the Barmer eCare is equipped with functions that go beyond those prescribed by law. Our aim is to provide the insured with the best possible support in managing their health.

This includes, for example, taking reminders tailored to the individual medication plan in order to strengthen adherence to therapy. Even patients who do not have a medication plan can keep their own medication list. If they agree, patients will receive preventive offers from Barmer and health information, for example about prevention courses in their area or advice that will help reduce the risk of infection from seasonal infections.

These additional Barmer eCare services do not interfere with the doctor-patient relationship. They are optional and free of charge for the patient.